Prognostic Importance of NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Following High-Risk Myocardial Infarction in the PARADISE-MI Trial
Authors' conclusion
Within the first week of a high-risk MI NT-proBNP is associated with incident HF, death and atherosclerotic events. This prognostic information is independent of hs-cTnT.
Study context
- Population
- Patients with acute myocardial infarction (MI) complicated by LV systolic dysfunction, pulmonary congestion, or both and ≥1 of 8 risk-augmenting factors; prior heart failure (HF) excludedprespecified substudy
- Participants
- 1,129 patients
- Comparison
- Prognostic value of baseline NT-proBNP
- Primary endpoint
- CV death or incident HF (hospitalization or outpatient symptomatic HF), time-to-first event
Methodological detailsprespecified substudy
- Prespecified substudy
Primary result
As reported in the abstract
CV death or incident HF, per doubling of NT-proBNP
Adjusted HR per doubling of NT-proBNP
1.45
95% CI 1.23–1.70
Further findings
Baseline NT-proBNP at randomization (4.0±1.8 days after index MI)
- Median NT-proBNP, ng/L (25th-75th percentiles, 896-3462 ng/L)
- 1757
All-cause death, per doubling of NT-proBNP
- Adjusted HR
- 1.74 (95% CI 1.38-2.21)
Fatal or nonfatal MI or stroke, per doubling of NT-proBNP
- Adjusted HR
- 1.24 (95% CI 1.05-1.45)
Modification of treatment effect (sacubitril/valsartan vs ramipril) by NT-proBNP
- NT-proBNP did not significantly modify the neutral treatment effect
- P for interaction = 0.46
Original publication
Prognostic Importance of NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Following High-Risk Myocardial Infarction in the PARADISE-MI Trial. Circ Heart Fail. Published 1 May 2023. doi:10.
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